Title: Medical Jurisprudence as it Relates to Insanity, According to the Law of England
Author: Haslam, John
Language: English
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                        MEDICAL JURISPRUDENCE,

                           AS IT RELATES TO

                               INSANITY,

                             ACCORDING TO

                          THE LAW OF ENGLAND.

                         BY JOHN HASLAM, M.D.

                   LATE OF PEMBROKE HALL, CAMBRIDGE.
       FORMERLY PRESIDENT OF THE ROYAL MEDICAL, NATURAL HISTORY
                 AND CHEMICAL SOCIETIES OF EDINBURGH.

                                London:
           PRINTED FOR C. HUNTER, LAW BOOKSELLER, BELL YARD;
           J. HUNTER, ST. PAUL’S CHURCH YARD; AND TAYLOR AND
                         HESSEY, FLEET STREET.

                                 1817.



PREFACE.


The consideration, that in our own language, no work existed on the
subject of Medical Jurisprudence, as it relates solely to Insanity,
urged me to the present performance. Previously to this undertaking
manifold impediments were foreseen, and these difficulties have
augmented in every page of its progress:—the apprehensions from
this arduous attempt, have, however, been mitigated by the consoling
reflection, that in a novel enterprize criticism would be tempered with
candour.

The following sheets are addressed to the readers of different
pursuits, law and medicine:—from the latter, I have heretofore
experienced much indulgence and encouragement, when the result of my
professional labours has been submitted to their judgment:[i:A]—to the
former I am little known: and here feel it necessary, by a distinct
avowal, to assert that I have in no manner presumed to encroach on
their province. Although the title may seem to imply an incorporation
of the two sciences, yet it is not to be considered as the combination
of definite proportions of legal and medical knowledge. It has been
modestly conceived that the general phenomena of disordered intellect,
and the criteria of insanity, would not be unacceptable to the
advocate; who might thereby become enabled to adapt the facts in
nature to the scale of justice. Furnished with such information, he
will be instructed to institute appropriate enquiries for the discovery
of truth, and to ascertain what is the duty of the medical evidence
to supply:—so that he may not be pressed beyond his resources, nor
the depths of his intelligence be left unsounded. On the practitioner
of my own profession I have ventured to impress the importance and
moral obligation of his evidence before the tribunal of justice, and
to enforce, that the value of medical opinion becomes enhanced by
perspicuity of conveyance, and derives authority from the exposure
of its foundations. It has likewise been my object, to direct his
attention to those leading points which usually constitute the subjects
of his deposition, or are presented for his solution during the course
of legal examination.

    [i:A] Vide Observations on Insanity, 8vo, 1798.—Observations
    on Madness and Melancholy, 8vo, 1809.—Illustrations of
    Madness, 8vo, 1810.—Considerations on the Moral Management of
    the Insane, 8vo, 1817.

The technical language of the learned professions is commonly
inveloped in mysterious obscurity:—persons for the most part acquire
names without investigating their force and legitimate import; and
currently employ them rather from habit than comprehension: it has
therefore been my anxious endeavour to scrutinize words of important
meaning; and to convey the manifestations of mind and the symptoms of
disease, by expressions generally understood, and emancipated from the
thraldom of professional nomenclature.

To complete the plan I originally projected, there still remains to
submit to the notice of the public, “The consideration of insanity in
a political view,” enquiring how far human wisdom, properly directed,
might become the instrument to diminish this severe and encreasing
affliction,—and especially to point out the desiderata for a _bill_
to protect the insane, and regulate the receptacles wherein they may
be confined. Notwithstanding the heterogeneous mass which has been
authoritatively diffused on this important subject, the necessary
materials have not yet been collected. Those who will probably attempt
to frame this measure, have much to learn, and more to dismiss. The
production of a wise and salutary bill requires ample research and
temperate reflection: and therefore can never be the offspring of minds
void of information, and saturated with prejudice. As Insanity is a
disease, by the unanimous concurrence of physicians, most certainly
to be remedied at the commencement of its attack: it ought to be a
leading object with those who possess the power to legislate, to afford
every facility to the medical attendant, that he may have an early
access to the treatment of this malady, for the restoration of the
patient, and for the security of the public. But if the practitioner
is to be pinioned by threats, or deterred by obloquy—if his skill
is to be circumscribed by ignorance, and his experience subjected to
wild hypothesis, and baseless conjecture; then, the enactment will be
oppressive in its operation, and incompetent to meet the exigences of
intellectual calamity—a bill, calculated to confirm and aggravate the
horrors of madness—to invite suicide, and multiply murder.

                                                     JOHN HASLAM.

         _1st December, 1817,
    51, Frith Street, Soho Square._



    ON

    Medical

    JURISPRUDENCE,

    _&c. &c._


Medical Jurisprudence has been assiduously cultivated by the different
nations of the European Continent; and many works of great value and
esteem have been produced by foreign professors of medicine on this
important subject. In our own country this department of medical
science has been comparatively neglected.[1:A] It is not my intention,
in the present tract, to enter generally on the subject of Forensic
Medicine: but to confine my investigation to that particular branch
which relates to persons of insane mind, and who under the visitation
of this dreadful calamity commit acts of violence which subjects them
to be arraigned before the tribunal of Justice, or to have their
property vested in trust by finding a verdict on a writ de Lunatico
inquirendo.

    [1:A] Vide an Epitome of Juridical or Forensic Medicine,
    by George Edward Male, M. D. a work of great excellence
    and scientific discrimination; also Tracts on Medical
    Jurisprudence, by Drs. Johnson, Bartley, and Farr.

Although of the utmost consideration, the extent of this enquiry would
seem to be very limited, and contained in this simple question. Is the
person accused, of insane mind? If he be insane he will be acquitted on
the _proof_ of his insanity—if he be not of insane mind, he must be
treated as an ordinary delinquent. In those cases where the prisoner
is so bereft of his reason, that any twelve men would not entertain
a different opinion, where numerous evidences appear to testify to
repeated acts of insanity, which are so manifest that they cannot be
otherwise interpreted; and where he has been confined and treated for
this malady, the physician will have an easy duty to perform: but it is
in cases which appear to be involved in difficulty, where the disorder,
although existing and directing the actions, is not so ostensibly
developed that the medical evidence becomes important, and capable by
sagacity, experience and truth, of explaining and characterizing the
state of the person’s intellect.

The important duty which the medical practitioner has to perform,
when he delivers his testimony before a court of justice, should be
clearly defined, conscientiously felt, and thoroughly understood,—his
opinion ought to be conveyed in a perspicuous manner; he should be
solemnly impressed that he speaks upon oath, the most sacred pledge
before God between man and man—and that the life of a human being
depends on the clearness and truth of his deposition. He is not to
palm on the court the trash of medical hypothesis as the apology for
crime; neither should the lunatic receive his cure at the gallows by
the infirmity of his evidence—but above all his opinion should be
so thoroughly understood by himself; so founded in experience and
fortified by reason, that it may resist the blandishments of eloquence
and the subtil underminings of cross-examination. The physician should
not come into court merely to give his opinion—he should be prepared
to explain it, and able to afford the reasons which influenced his
decision:—without such elucidation, Opinion becomes a bare Dictum,
and endeavours to claim precedence, without courtesy or obligation to
science.

It is to be regretted that on many occasions where several medical
practitioners have deposed, there has been a direct opposition
of opinion:—this difference has sometimes prevailed respecting
insanity,[5:A] but more frequently in cases of poison. It is not
intended to account for this contrariety of evidence: much will depend
on the sagacity of the counsel to institute the proper enquiries;
and still more will be incumbent on the medical evidence, in order
to explain and establish his testimony. On one side the evidence
will be positive; and it is to be presumed that no member of the
medical profession would directly state an individual to be insane
without being able, satisfactorily to his own reason and conscientious
feelings, to exhibit from his conversation, his actions or his
writings unequivocal proofs of his derangement. To such well founded
illustration, negative evidence would but little avail.

    [5:A] Vide my Illustrations of Madness.

The Lawyers object is the interest of his employer, and for the
fulfilment of his duty he is frequently compelled to resort to a
severity of investigation which perplexes the theories, but more
frequently kindles the irritable feelings of the medical practitioner.
This distrust on the part of the lawyer, however unpalatable, is fully
justified: most witnesses going into court, not with a wish to be
examined, but with the preconcerted intention of _proving_ to a certain
extent;—and those most conversant in the history of human testimony,
have been extremely scrupulous of admitting it as uniform truth until
it has been carefully sifted. Guarded with these precautions and armed
with professional experience, the medical practitioner may approach
the tribunal of justice with confidence, and advantage to the cause
of truth. However dexterous he may shew himself in fencing with the
advocate, he should be aware that his evidence ought to impress the
judge, and be convincing to the jury. The most experienced physician
who has seen insanity in all its forms, and viewed its more delicate
shades, must in a question of this nature submit his opinion, to the
comprehension and feeling of the ordinary persons who are to appreciate
his deposition. Their BELIEF of the alleged insanity must be
the test by which his scientific opinion is to be established. That
which may be deemed by the medical evidence, clear and unequivocal
madness, may not hit the sense of the gentlemen of the long robe, nor
carry conviction to the jury.

It may here be important to investigate the sources from whence
the popular feeling and intelligence concerning madness have been
derived; or in other words, what are the foundations for the opinions
of the generality of persons, on the subject of insanity? Patient
enquiry, daily communication with deranged persons and attentive
observation of their habits, confer the means of judging on medical
practitioners, and more especially on those, who have for a series
of years, solely confined their practice to this department of the
profession. The information of the lawyer is principally deduced from
the writings of those great legal authorities to which he refers with
confidence;—although these grave authorities have laid down _no
definition of madness_, nor given any directions how to discover it.
The ordinary class of persons, who are usually summoned to act as
Jurymen; and who are sufficiently virtuous and intelligent; have in
common with the mass of mankind formed their opinions of that state of
mind which is denominated madness, and it should be observed that such
opinions are not very easily removed or altered. It will be a curious
and instructive enquiry, to investigate the circumstances which have,
in all probability, contributed to fix their notions on the subject
of insanity. They have wanted the means of direct information, and
consequently have adopted the popular and floating opinions on this
disease. That dramatic representations have forcibly operated for
this purpose there is little reason to doubt: and some of the plays
of Shakespear exhibit many of the forms which this malady is supposed
to assume. Among such characters, none have more strongly fastened
on the general mind, than the outrageous Lear, and the distracted
Ophelia; the subtil craziness of Hamlet leaves it doubtful if his
alienation of mind be real, or conveniently assumed—and to the
ordinary observer conveys more of fiction, than the avowed counterfeit
of Edgar. Romances, the literary food of the idle and thoughtless,
abound in descriptions of intellectual calamity;—but these artificers
of fancy, like many unskilful performers, are too prone to strain the
loftier impressions of feeling, and distort the energies of passion,
into mental derangement. Something of affecting interest may be
excited by the weaknesses and wanderings of Maria, but Cervantes has
exhibited the happiest and most correct picture of systematic insanity;
although the vehicle of chivalry in which it is conveyed, has, to our
own countrymen, blunted its interest as a physiological portrait of
madness:—his sallies have provoked mirth, and so keen is the relish
for the ridiculous, that in the luxury of laughter, the reader has
forgotten the tribute of commiseration. Within my own recollection
Bethlem Hospital gratified the curiosity of the vulgar of both sexes;
these visitors were most eager to penetrate into the recesses of the
furious and naked maniac: the hideous howlings of those violently
affected, forcibly arrested their attention. With the insane of a
milder cast, they were but slightly interested; except the singularity
of their actions, or incoherence of discourse were calculated to
excite their merriment. They were much delighted with the archness of
retort and ridiculous buffoonery which often forms a striking feature
in the character of the insane. They were particularly gratified at the
manner in which they frequently ornament their persons: a straw crown
or sword of the same material pleasingly occupied their attention;—but
they passed over the silent and melancholic, and usually retired with
the impression, that the quiet and orderly were convalescent, or
improperly confined. To impress ordinary persons with the existence of
insanity, some prominent and strongly marked features are absolutely
required; as the popular feeling and intelligence concerning madness
is the result of those glaring exhibitions, those caricatures of
disease which the stage represents or romances propagate. Of methodical
madness, of systematic perversion of intellect, the multitude can
form no adequate conception, and cannot be persuaded that insanity
exists without turbulent expression, extravagant gesture, or phantastic
decoration. The converse of this has likewise, not unfrequently
obtained; and even among those who might be supposed to possess
superior information.—Hesitation of speech, nervous and convulsive
affections—uncouth gestures resembling St. Vitus’ dance, absence
of mind—dulness in comprehending a question, with tediousness and
embarrassment in affording the reply, have often induced the mistaken
supposition that the party was insane.

On those occasions where the madman has been tried in a criminal court,
the counsel for the prosecution has usually and gravely enquired of
the medical evidence, whether the prisoner on ordinary topics and
on subjects unconnected with his insanity, would not converse in
a rational manner: and also whether he did not possess sufficient
understanding to discriminate between GOOD and EVIL, RIGHT and WRONG?
When a medical person is employed concerning any one to whom insanity
is imputed, his principal enquiry is concerning his _in_sanity: it
is not his object to ascertain how much reason he possesses, but how
far, and on what topics he is insane. And having gauged his insanity
he has performed his duty. If it should be presumed that any medical
practitioner is able to penetrate into the recesses of a lunatic’s
mind, at the moment he committed an outrage; to view the internal play
of obtruding thoughts, and contending motives—and to depose that he
knew the GOOD and EVIL, RIGHT and WRONG he was about to commit, it
must be confessed that such knowledge is beyond the limits of our
attainment. It is sufficient for the medical practitioner to know
that his mind is deranged, and that such state of insanity will be
sufficient to account for the irregularity of his actions; and that in
a sound mind, the same conduct would be deemed criminal. If violence
be inflicted by such person during a paroxysm of rage, there is no
acuteness of metaphysical investigation which can trace the succession
of his thoughts, and the impulses by which he is goaded for the
accomplishment of his purpose. And it will be shewn hereafter that in
some instances he is not himself conscious of his actions. Should an
equal injury be inflicted by the crafty and deliberate machinations
of systematic insanity, where the motives to action are delusions,
the scrutiny into the exact procession of thought which produced the
motive, or excited the determination is likewise beyond the reach of
the medical practitioner. As it would be difficult in a person of the
soundest mind to detect the succession of thoughts, tracing that which
was most remote _from_, to that which was proximate _to_, the action;
it can less be expected that the medical evidence should be capable of
noting the consecutive irregularities of a disordered intellect.

Respecting the quantum of reason which the lunatic possesses, the
physician may safely conclude, where he betrays no derangement, that on
such topics he is of sound mind; and the fact is firmly established,
that those who are insane on particular subjects, will reason correctly
on ordinary and trivial points; _provided they do not become associated
with the prevailing notions which constitute their insanity_. Ordinary
persons have been much deceived by this temporary display of rational
discourse, and it generally occurs that we are disposed to form a hasty
conclusion, in proportion to the paucity of our knowledge on any given
subject:—most minds feel more invited to indulge in the convenience
of a syllogism, than to undergo the toil of induction. Although an
insane person may be calm and apparently rational at the beginning
of an interview, yet when least expected his disorder breaks forth,
and in many instances, there seems to be no cause for this conversion
from apparent sanity to evident derangement. In the commencement of
the conversation the lunatic shall evince a healthy perception of
existing objects, and institute a just admeasurement of the subject
under contemplation; or in other words shall reason correctly; if he
be placed in the society of other madmen he is able to detect the
folly and aberration from reason which characterize their peculiar
phantasies, and will often endeavour to convince them of the absurdity
of their prevailing opinions, yet in a moment his mind launches into
the regions of fiction, its admired clearness becomes obscured, and
its seeming regularity exhibits a confused assemblage or violent
distortion.—There is no intermediate condition which separates these
states: and the transition very much resembles the last connected
glimpses of our waking thoughts, followed by the abrupt creation of a
dream.

This occasional display of rationality, although admitted by all who
have had experience of the insane, excites a doubt in the minds even
of learned and intelligent persons who have merely speculated on this
disease. They have conceived, from the existing philosophy of the
intellect, that reason is the directress of human actions,—that this
high arbiter of thought is an undivided principle,—that where the
rudder is attached the ship may be steered—and that he who reasons
must be rational: and so he is, _as long_ as he _does_ reason. But the
inference of the integrity of the reasoning faculty in consequence
of occasional gleams, is a gratuitous and groundless supposition. It
often happens that persons may converse for some time with a lunatic,
and find him apparently composed and rational; he will discuss the
floating topics of the day as another man,—accord with the most
enlightened on the general principles of morals, and correctly estimate
the light and shadow of human conduct. If the observer should here
retire he might be convinced of his sanity: but let him protract the
discourse, let him touch the fatal string which throws his mind into
discord: let him draw the hair-trigger which inflames the combustible
materials of his disease, and he will be surprised if not alarmed at
the explosion. The sweeping tyranny of madness scorns the demarcation
which limits the sober mind; and it should likewise be taken into
account that the subjects which constitute the insanity of a person,
are the prominent features of his mind, and are more frequently
recurred to than any other. It is true he may discuss ordinary topics
like other men; but this to him is a species of bye-play, and he soon
reverts to the interest or catastrophe of his drama. Whatever may be
the subject of discourse, and however rationally he may appear to treat
it, the experienced practitioner will expect, and he will not often
be disappointed, to find that by some unaccountable association, even
ordinary topics are linked with his darling delusion,—the map of his
mind will point out that the smallest rivulet flows into the great
stream of his derangement.

On a more attentive consideration, there appears to be something latent
and perhaps mischievous, in the terms GOOD and EVIL, RIGHT and WRONG,
as applied to cases of insanity. If an _insane_ person be responsible
for his conduct, I know of no law which sanctions his confinement. If
he can discriminate between GOOD and EVIL, RIGHT and WRONG, on what
pretence is he to be deprived of his liberty? Is it humane to suppose
him in his senses when he becomes most outrageous? Is it christian-like
to deem him responsible, because the violence of his disorder tears
down the fences of the law, or snaps the ties of natural affection?
Ought he to be punished when he is most to be pitied? If it be supposed
that the terror of example will prevent the sallies of the maniac, it
is a lamentable mistake. His belief in the GOOD of his principle, his
faith in the RIGHT of his actions, are superior to arguments,—his
motive cannot be controlled by reason, nor baffled by the fear of
punishment. Impressed with a _belief_ in the truth of his delusion,
he hurries forward to its accomplishment: and in the pursuit of the
phantom cannot be diverted by the most awful consequences. He is of
those

                “quem neque pauperies
    “Neque mors, neque vincula terrent.”

It is this firm belief, this fond indulgence of opinion which makes him
prefer seclusion to liberty; and leads him rather to forego existence
than renounce his delusion. It is the same principle, which in a good
cause, cheered the martyr at the stake, and raised his exultation while
the flame consumed him. It is this BELIEF, however erroneous, which
kindles enthusiasm in a cause, and arms us to defend it.

As the word BELIEF is important, it will not be considered
unnecessarily digressive to attempt an investigation of its legitimate
meaning. There are two modes of ascertaining the meaning of a word;
either by referring to its etymology, to discover the cause of
its application: or to collect the authorities which shew, that
certain persons who are accredited, have so employed it. By turning
to Dr. Johnson’s Dictionary the reader will find that the different
authorities which he has cited have used this word in different
acceptations. Without descending to the minutiæ of verbal examination,
and tracing back its derivation to its Gothic or Saxon radical, it may
be safely asserted, that to BELIEVE, originally implied to belove: to
be attached or partial to, independantly of any evidence which would
lead to demonstration. This belief is the immediate motive to action,
and although incapable of becoming the subject of demonstration itself,
is not to be set aside by the clearest and most forcible refutation.

                            “You may as well
    “Forbid the sea for to obey the moon,
    “As by an oath remove, or counsel shake
    “The fabric of his folly, whose foundation
    “Is pyld upon his faith.”

                                            _Winter’s Tale._

It would be a curious and instructive enquiry to ascertain under what
circumstances the mind admits as rules for action, those principles
which do not admit of proof: because, if we could detect the manner
in which the knot is tied, we might probably be able to unloose it.
In the course of our education we are taught to adopt many maxims,
the truth and expediency of which may not be very evident; however as
we advance in life, experience and good sense gradually dispel many
of these prejudices and erroneous adoptions. But in the insane mind
the same process does not take place, and generally in proportion to
the reasoning adduced to confute the delusion, or the demonstration
employed to exhibit its absurdity, it becomes more strongly confirmed
and inveterately fixed; and the logic brought forward for its
refutation, is by the lunatic held as ignorance or misapplication. A
person _in_ his senses may entertain and believe a number of unfounded
and erroneous opinions, but on the exposure of their falsity he is
capable of being convinced, but the madman never is; and this forms the
great distinction between them. This incapability of being convinced of
the GOOD and EVIL, RIGHT and WRONG, TRUTH and FALSHOOD of his BELIEF
is that, which as an intellectual being, renders him different from
other men, and constitutes his distemper. To our present purpose,
it is immaterial how this arises, the knowledge of its existence is
sufficient: and it concerns us but little to ascertain if this state
depend on a morbid condition of the intellect itself, or of the organ
destined for the display of its phenomena.

This belief appears physiologically to constitute his disorder; and
the hope of placing this subject in a distinct point of view may be an
apology for the relation of the very remarkable case of Nicolai of
Berlin.[25:A] In consequence of a series of calamities which afflicted
him with the most poignant grief he had in January and February of
the year 1791, the additional misfortune to experience several very
unpleasant circumstances which were followed on the 24th of February
by a most violent altercation. “My wife and another person came into
my apartment in the morning in order to console me, but I was too much
agitated by a series of incidents which had most powerfully affected
my moral feeling, to be capable of attending to them; on a sudden I
perceived, at about the distance of ten steps, a form like that of a
deceased person, I pointed at it, asking my wife if she did not see
it? It was but natural that she should not see any thing, my question
therefore alarmed her very much, and she sent immediately for a
physician, the phantasm continued about eight minutes. I grew at length
more calm, and being extremely exhausted, fell into a restless sleep,
which lasted about half an hour; the physician ascribed the apparition
to a violent mental emotion, and hoped there would be no return,
but the violent agitation of my mind had in some way disordered my
nerves, and produced farther consequences which deserve a more minute
description.

    [25:A] Vide Ferriar on Apparitions, P. 41.—As the Doctor has
    not cited whence he obtained this curious document, I have been
    under the necessity of employing perhaps his own translation.

“At four in the afternoon, the form which I had seen in the morning
reappeared. I was by myself when this happened, and being rather uneasy
at the incident, went to my wife’s apartment, but there likewise I was
prevented by the apparition, which however, at intervals disappeared,
and always presented itself in a standing posture: about six o’clock
there appeared also several walking figures, which had no connexion
with the first.

“I cannot assign any other cause of all this, than a continued
rumination on the vexations I had suffered, which, though calmer,
I could not forget, and the consequences of which I meditated to
counteract: these meditations occupied my mind three hours after
dinner, just when my digestion commenced. I consoled myself at last
with respect to the disagreeable incident which had occasioned
the first apparition, but the phantasms continued to increase and
change in the most singular manner, though I had taken the proper
medicine and found myself perfectly well. As when the first terror
was over, I beheld the phantasms with great emotion taking them for
what they really were, remarkable consequences of an indisposition,
I endeavoured to collect myself as much as possible, that I might
preserve a clear consciousness of the changes which should take
place within myself; I observed these phantasms very closely, and
frequently reflected on my antecedent thoughts to discover, if
possible, by means of what association of ideas exactly these forms
presented themselves to my imagination. I thought at times I had
found a clue, but taking the whole together I could not make out any
natural connexion between the occupations of my mind, my occupations,
my regular thoughts, and the multifarious forms which now appeared to
me, and now again disappeared. After repeated and close observations,
and calm examination, I was unable to form any conclusion relative to
the origin and continuation of the different phantasms which presented
themselves to me. All that I could infer was, that while my nervous
system was in such an irregular state, such phantasms would appear
to me as if I actually saw and heard them; that these illusions were
not modified by any known laws of reason, imagination, or the common
association of ideas, and that probably other people who may have had
similar apparitions were exactly in the same predicament. The origin
of the individual forms which appeared to me, was undoubtedly founded
on the nature of my mind, but the manner in which it was thus affected
will probably remain for ever as inscrutable as the origin of thought
and reflection. After the first day, the form of the deceased person no
more appeared, but in its place there appeared many other phantasms,
sometimes representing acquaintances, but mostly strangers: those whom
I knew were composed of living and deceased persons, but the number of
the latter was comparatively small. I observed the persons with whom I
daily conversed did not appear as phantasms, these representing chiefly
persons who lived at some distance from me. I attempted to produce at
pleasure phantasms of persons, whom I knew by intensely reflecting on
their countenance, shape, &c. but distinctly as I called to my lively
imagination the respective shades of three of these persons, I still
laboured in vain to make them appear to me as phantasms, though I had
before involuntarily seen them in that manner, and perceived them some
time after, when I least thought of them. The phantasms appeared to
me contrary to my inclination, as if they were presented to me from
without, like the phenomena of nature, though they existed no where
but within my mind. I could at the same time distinguish between
phantasms and real objects, and the calmness with which I examined
them, enabled me to avoid the commission of the smallest mistake. I
knew exactly when it only appeared to me that the door was opening and
a phantasm entering the room, and when it actually opened, and a real
person entered. These phantasms appeared equally clear and distinct at
all times and under all circumstances, both when I was by myself and
when I was in company; and as well in the day as at night, and in my
own house as well as abroad; they were, however, less frequent when I
was in the house of a friend, and rarely appeared to me in the street;
when I shut my eyes these phantasms would sometimes disappear entirely,
though there were instances when I beheld them with my eyes closed,
yet when they disappeared on such occasions, they generally reappeared
when I opened my eyes. I conversed sometimes with my physician and my
wife of the phantasms which at the moment surrounded me; they appeared
more frequently walking than at rest, nor were they constantly present.
They frequently did not appear for some time, but always reappeared for
a longer or a shorter period either singly or in company, the latter
however being most frequently the case. I generally saw human forms of
both sexes, but they usually appeared not to take the smallest notice
of each other, moving as in a market place, where all are eager to
press through the crowd; at times however they seemed to be transacting
business with each other: I also saw several times people on horseback,
dogs and birds. All these phantasms appeared to me in their natural
size, and as distinct as if alive, exhibiting different shades of
carnation in the uncovered parts, as well as in different colours
and fashions in their dresses, though the colours seemed somewhat
paler than in real nature, none of the figures appeared particularly
terrible, comical, or disgusting, most of them being of an indifferent
shape, and some having a pleasing appearance.

“The longer these phantoms continued to appear, the more frequently did
they return, while at the same time they encreased in number about four
weeks after they had first appeared. I also began to hear them talk,
the phantoms sometimes conversed among themselves, but more frequently
addressed their discourse to me; their speeches were commonly short
and never of an unpleasant turn. At different times there appeared
to me both dear and sensible friends of both sexes, whose addresses
tended to appease my grief, which had not yet wholly subsided: these
consolatory speeches were in general addressed to me when I was alone,
sometimes I was accosted by these consoling friends while in company,
frequently while real persons were speaking to me; these consolatory
addresses consisted sometimes of abrupt phrases, and at others they
were regularly connected.

“Though both my mind and body were in a tolerable state of sanity all
this time, and these phantasms became so familiar to me, that they did
not cause me the slightest uneasiness, and I even sometimes amused
myself with surveying them, and spoke jocularly of them to my physician
and my wife; yet I did not neglect to use proper medicines, especially
when they began to haunt me the whole day, and even at night as soon as
I awaked.

“At last it was agreed that leeches should be again applied to me,
as formerly; which was actually done April 20th, 1791, at eleven
o’clock in the morning. No person was with me besides the surgeon; but
during the operation my chamber was crowded with human phantasms of
all descriptions. This continued uninterruptedly till about half an
hour after four o’clock, just when my digestion commenced. Soon after
their colour began to fade, and at seven o’clock they were entirely
white. But they moved very little, though the forms were as distinct
as before: growing however by degrees more obscure; yet not fewer in
number as had generally been the case. The phantoms did not withdraw,
nor did they vanish; which previous to that time had frequently
happened. They now seemed to dissolve in the air: while fragments
of some of them continued visible a considerable time. About eight
o’clock the room was entirely cleared of my fantastic visitors.”

This very interesting relation by the patient himself, is here
introduced in preference to other cases which have fallen under my own
experience: but all of which are inferior in interest, and accuracy of
observation. Nicolai was a man of unquestionable veracity, of liberal
education, and a distinguished author. Although he laboured under a
delusion, by seeing and hearing those things which did not exist, yet
his belief in their reality was never subscribed:—on the contrary, he
knew them to be delusions,

    “A false creation, proceeding from the heat-oppressed brain.”

These apparitions were obtruded on his vision, and their voices struck
his ear. Notwithstanding these phantoms had the

    “Power to cheat the eye with blear illusion,”
    “_And give it false presentments_,”——

still he was persuaded that his perception was beguiled. Had he
believed in their existence and acted from a conviction of their
reality he ought to have been deemed insane. But under Nicolai’s own
relation of his capability to discriminate illusion from reality, the
conclusion is fully warranted, that he was a being responsible for his
actions.

It may here be proper to direct the attention of the reader to the
motives which have frequently impelled those of unsound mind to the
injury or destruction of their fellow creatures:—and from my own
experience many have been prompted by a dream or vision, which has
been so distinctly revealed and forcibly impressed, that it has
carried the conviction of reality and divine command. Some hear voices
and obey the mandates which are thus whispered from a BELIEF in the
superior authority which has issued them; and after an outrage has
been perpetrated by one of these maniacs, it is astonishing with what
coolness and satisfaction he will attempt to justify its necessity, and
even undismayed advance to the scaffold. If therefore, there be the
same BELIEF in delusion as in reality—if the maniac be persuaded that
his vision has brought him into the presence of the Almighty, or that
the fancied voice is the divine command, he becomes the subject of pity
and protection, but not of punishment. If he be acknowledged insane
upon many subjects, and kills another, should he be supposed of sound
mind on account of having committed such outrage? Is he to be judged
from the state of his intellect, or by the atrocity of the action?

However the maniac may direct the sallies of his violence and
resentment against the lives of others, frequently of those to whom he
is nearest allied, or bound by obligation and friendship: yet there is
another feature which his disorder assumes, and which always secures
the commiseration of mankind. It more frequently occurs in the deranged
state of these pitiable persons that they seek to revenge on themselves
the supposed crimes they have committed. In our own country, there are
more lunatics who destroy themselves, than attempt the lives of others;
and in these cases the Coroner’s jury has always agreed on a merciful
interpretation. Indeed there are but few instances of the impotent
folly of degrading the carcass, excepting where self-destruction has
anticipated the rigour of the law.

It is of frequent occurrence, that persons labouring under insanity,
although of exemplary lives and unblemished character, shall believe
themselves guilty of the most atrocious crimes;—reputation, the
dearest possession of the sound mind is sacrificed without a regret by
the despairing lunatic;—he accuses himself of cowardice, of fraud,
of secret murder, or of a turpitude at which man revolts:—and others
blessed with opulence, and enjoying those comforts which render life
desirable, become apprehensive of terminating their existence in the
work-house. Sometimes the desire of death is so ardent, that they will
perpetrate any crime in order to be arraigned and condemned at the bar
of justice. Of this extraordinary perversion I shall take the liberty
to relate a very striking instance.

A woman about 36 years of age, who had been well educated, but whose
conduct had not been exempt from some irregularities, in consequence
of intemperance and manifold disappointments, became affected with
madness. She was by turns furious and melancholic, and conceived
she had murdered one of her children, for which she ought to suffer
death. She detailed the manner in which she had destroyed the child
and the motives which actuated her, so circumstantially, and with so
much plausibility and feeling, that if I had not known her child to be
living I might have been deceived. By her own hands she had repeatedly
endeavoured to terminate her existence, but was prevented by constant
vigilance and due restraint. Her disposition to suicide was afterwards
relinquished; but she still persisted that for the murder of the child
she ought to suffer death, and requested to be sent to Newgate, in
order to be tried, and undergo the sentence of the law:—indeed she
appeared to derive consolation from the hope of becoming a public
example, and expiating her supposed crime on the scaffold. While in
this state, and with a hope of convincing her of its safety, the child
was brought to visit her. When she beheld it there was a temporary
burst of maternal affection; she kissed it, and for a few moments
appeared to be delighted:—but a look of suspicion quickly succeeded,
and this was shortly followed by a frown of indignation, which rendered
the removal of the child a measure of wholesome necessity. Perhaps,
in no instance, was the buoyancy of madness more conspicuous over
reason, recollection, and feeling. She insisted they had attempted
to impose on her a strange child, which bore a faint resemblance to
her own; however, by such subterfuges she was not to be deceived; she
had strangled the child until life had totally departed, and it was
not in the order of nature that it should exist again. The effect of
this interview was an exasperation of her disorder,—she became more
cunning and malignant, and her desire for an ignominious death was
augmented. To render this more certain, and accelerate her projected
happiness, she enticed into her apartment a young female patient, to
whom she appeared to be attached, and having previously platted some
threads of her bed-quilt into a cord, she fixed it round the neck
of the young woman and proceeded to strangle her. Fortunately some
person entered the room, and unloosed the cord in time to save her.
When this unhappy maniac was questioned concerning the motive which
induced her to attempt the destruction of a person for whom she had
manifested kindness; she very calmly replied, that as the murder of her
own child was disbelieved, she wished to exhibit a convincing proof
of the ferocity of her nature, that she might instantly be conveyed
to Newgate, and hanged, which she desired as the greatest blessing.
With considerable satisfaction I may add, that in a few months,
notwithstanding her derangement had been of three years duration, this
woman perfectly recovered, and for a considerable time has performed
the duties of an important and respectable office.

Influenced by curiosity, and a wish for the advancement of
professional knowledge, I have always been induced to scrutinize as
deeply as possible into the feelings of lunatics who have perfectly
recovered; I therefore wished to be informed from this patient in
her sane state, what were her feelings and opinions concerning her
former condition. She recollected most of the circumstances which
had transpired during her illness, but she was unable adequately to
comprehend, or to give any account of her disorder—it seemed to
her like a wearisome and protracted dream, but more distinct and
connected—she almost doubted with her present feelings if she could
be the same person, to have entertained opinions and resentments so
different from her natural character. When questioned concerning
her attempt to strangle the young woman, she rejoiced that no
fatal consequences had ensued, yet she seemed to attach but little
responsibility to any thing she might have committed in that frame of
mind. Death, from which, as other human beings, she now shrunk with
horror, was then the most desirable of all events.—Respecting the
child, she observed her mind was as suddenly seized with the conviction
that she had destroyed it, as a person is attacked with the shivering
fit of an ague, and feels the sensation of cold in the hottest day of
summer. On enquiring if these former impressions often recurred to her
mind; she replied in the negative;—that although she could accurately
recollect them when questioned, yet they now seemed removed to a vast
distance from the natural range of her thoughts:—and that she found
herself pleasantly occupied in contriving plans for the welfare and
happiness of her future life.

It is therefore not the fear of death which can arrest the projects
of the maniac mind; for on many occasions they seek it as the greatest
consolation; and quietly submit to seclusion and its consequent
privations sooner than renounce their opinions, or withhold their
endeavours to accomplish that which appears to them, from the
disordered state of their intellect, GOOD and RIGHT, and which by those
of sane mind is denominated EVIL and WRONG. A very different opinion
has however prevailed; and it has been conceived that the terror of
example would deter lunatics from following the dictates of their
distempered minds: and many worthy and pious persons who have been the
stanch fautors of the dignity of our species, have maintained, that the
Deity never so far abandons the being fashioned in his own likeness,
and to whom he has imparted a ray of his intellectual light, as to
deprive him of the power of discriminating between right and wrong.
To such assumptions, unsupported by reason, and clashing with daily
experience, the reader will not expect a serious reply—they must have
originated in minds more confident of the perfection and endurance of
the intellect, than grateful for its possession.

It is not the object of these pages to shelter crime under the pretence
of insanity; or to suppose that some degree of derangement must exist
in the mind of the perpetrator:—on the contrary, it is believed,
because every day furnishes instances, that men of the highest
attainments and most lucid faculties will deliberately commit acts of
turpitude,—foreseeing the consequences, and feeling the criminality of
the act. But, it would be as much the subject of regret and against the
law, that a human being, under a delusion which he firmly believed, and
in the persuasion that he was acting from the immediate influence or
instigation of the Divine command, should undergo the sentence of the
law to the disgrace of his family:—as that science should ever attempt
to contaminate the source of justice, by shielding criminality under
the cover of disease.

It has been stated in a former part of this tract, that the medical
evidence, in order to impress and satisfy the tribunal before which
his testimony is given, should not merely pronounce the party to be
insane, but ought to adduce sufficient reasons as the foundation of
his opinion. For this purpose it behoves him to have investigated
accurately the collateral circumstances. It should be enquired if
he had experienced an attack at any former period of his life?—if
insanity had prevailed in his family?—If any of those circumstances
which are generally acknowledged to be causes of this disease had
occurred? as injuries of the head, mercurial preparations largely
or injudiciously administered—attacks of paralysis—suppression of
customary evacuations, &c. It should likewise be ascertained, if
previous depression of mind had prevailed, resulting from grief,
anxiety or disappointment—and it should not be neglected to collect
any written documents; as insane persons will very often commit to
writing their feelings and opinions although they may suppress them in
discourse.

There appear however sufficient criteria to discriminate crime from
insanity, although it must be confessed, and such has been the
opinion of distinguished legal authority, that they have often seemed
to be intimately blended; yet there is a partition which divides
them, and it is by such well defined interposition that they are to
be separated:—for madness, clear and unequivocal insanity, must
be established by the medical evidence. It is not eccentricity,
habitual gusts of passion, ungovernable impetuosity of temper, nor the
phrensy of intoxication,[50:A] but a radical perversion of intellect,
sufficient to convince the jury that the party was bereft of the reason
of an ordinary man.

    [50:A] A broad distinction should be made between the immediate
    and remote effects of intoxication. A man is not held guiltless
    who perpetrates a crime during the state of intoxication.
    He voluntarily introduces into his system a stimulus which
    augments his ferocity, diminishes his moral affections, and
    overshadows his reason. But the usual effect of this stimulus
    is temporary, he awakes from his debauch rational, and commonly
    drags after him the heavy chain of reflection. It is however
    equally true that this single excess may be continued into
    permanent insanity: he may remain for many months in a state of
    mental derangment, and during the prevalence of his disorder
    may be compelled to forego all intoxicating beverage.—If such
    person after the elapse of several weeks from the commencement
    of his disorder, should, under its influence, commit a fatal
    outrage, no system of jurisprudence would connect the violence
    with the cause which originally produced the disease.

Notwithstanding the medical evidence may be incapable, totidem verbis,
to give a clear definition of madness, so as to be suited to the
conception of all persons, and to comprehend the various shapes of this
disease, on account of the various notions affixed by different persons
to the abstract terms he may employ; yet it is always in his power to
state such perversions of thought—such projects—and such conduct,
contradistinguished from that which all men hold to be rational, as
shall leave no doubt on the minds of those who are to appreciate his
evidence, that insanity exists: and if the person be really insane,
it must be from the ignorance or neglect of the medical practitioner,
if he do not satisfactorily establish his derangement, provided his
opportunities of visiting and conversing with the patient have been
sufficient.

In those cases where insane persons have deliberately destroyed others
there has been some existing and prominent delusion which has been
fully believed to be TRUE and GOOD and RIGHT, which has constituted
the motive, and urged on the miserable victim of this delusion to the
accomplishment of his purpose. Lord Erskine in the fewest words has
most impressively comprehended this subject, “_In cases of atrocity,
the relation between the disease and the act should be apparent_.”
And again, “_I think as a doctrine of law, the delusion and the act
should be connected_.” With the lunatic the object to be attained has
seldom been adequate to the hazard of the enterprize, nor has the
motive been proportionate to the violence committed: in the majority
of instances some previous intimation of the intended attack has been
communicated, if the object has been accessible; and the warning itself
has usually borne the stamp of a deranged intellect. These distempered
minds have never inflicted violence for private emolument, or personal
advancement, but have been persuaded, that they are selected from the
mass of mankind to confer exemplary justice, and to ameliorate the
condition of their species. The motive for the injury inflicted has
generally been virtuous and honorable in the deluded imagination of the
maniac. It is true that on most occasions there has been the utmost
subtilty of contrivance and deliberate execution of the projected
mischief, whether it has been directed against others, or exerted
for their own destruction. The execution of the project so far from
being unwise, has usually deceived and astonished the wisest; but the
principle, the firm belief, the motive to action, has been the “stuff
which dreams are made of.”

There is another form of this disorder under the influence of which
some insane persons become highly dangerous; but which has not been
hitherto sufficiently noticed, although it deserves the fullest
consideration. As several instances of this state have fallen under
my own observation I shall beg to relate two or three cases with as
much brevity as may adequately suffice to convey the facts. It has
been already remarked that some insane persons who have recovered
the proper direction of their intellects have thoroughly remembered
the particulars of their diseased state:—in the instances to be
related they have retained no trace of their disorder, nor any of the
circumstances which occurred during its continuance.

A very powerful man, above the ordinary stature, who in his youth
had been subject to epileptic attacks, and frequently to intervals
of sullen abstraction, which increased after the epileptic fits
had subsided, became suddenly furious, and during the transports
of his disorder destroyed two children and a woman. For this act
there appeared to be no motive. He was ordered to be confined, where
he continued until his death. For many years during his seclusion
I had constant opportunities of seeing and conversing with him.
He was ordinarily in a very tranquil state, and did not discourse
irrationally;—indeed there was no particular subject on which his mind
appeared to be disarranged, nor were there any persons against whom he
entertained an aversion. Much of his time was passed in reading, which
he said afforded him great consolation. On many occasions I endeavoured
to draw from him some account of the motives which induced him to
destroy the persons above-mentioned; but he uniformly and steadily
persisted that he had no recollection whatever of such occurrence. He
said, he understood he had done something which was very wicked, and
for which he was confined; and which he had no doubt was true, from
the respectability of the persons who informed him of his crime; but
he thanked God he had no more memory of what had passed than if it
had been committed in his sleep.—During the years of his confinement
he had many furious paroxysms, and in order to be fully satisfied of
the truth of his asseverations as to his want of recollection during
these attacks, he was once blooded at the commencement of the paroxysm,
although with considerable difficulty, and on another occasion cupped
when its violence was subsiding,—yet when he was restored to his
ordinary state of tranquility he neither recollected the persons
who were present nor the operations which had been performed.—Of
the same class of mental affection was the case of a young lady,
who became insane in consequence of having experienced some severe
disappointments. She attempted to destroy herself in various ways,
and was therefore obliged to be strictly restrained; but to others she
manifested no evil intentions. When spoken to, she returned correct
answers, although she never began a conversation. During the day she
sat apparently sullen and abstracted, and seemed to take no notice
of what was passing. After the elapse of three weeks, as she was
sitting in her usual manner, she uttered a shriek, appeared for a few
moments in a state of alarm and confusion, and suddenly recovered.—Of
her repeated attempts at suicide she had not the slightest
recollection.—When I visited her the following day she received me as
a perfect stranger; and was not conscious she had ever seen me before;
and during several subsequent interviews, in order to be certain of her
recovery, I was persuaded she did not retain the slightest remembrance
of any of the circumstances of her malady. A third case of this
nature lately occurred. A young man with hereditary predisposition to
insanity, his mother and grandmother having been so disordered; in
consequence of severe losses, was seized with a paroxysm of furious
madness, which continued without abatement for four months. At the
expiration of three months he had a considerable mortification on the
lower part of the back, which required surgical attention during three
weeks. When the sore was healed he was removed to another situation for
the treatment of his insanity, where he perfectly recovered. After his
complete restoration he neither recollected the asylum where he was
first placed, the disease of his back, nor his removal to the situation
where he ultimately regained his reason.

To the states of mind above described, the question of good and
evil can in no way apply; because these persons have wanted all
recollection of their state, and of any act perpetrated; which
implies that they were unconscious of any motive urging them to its
commission; and which being unremembered, renders them incapable, as
moral agents, of contemplating the RIGHT or WRONG of the act previous
to its execution. It is likewise well known, that even ideots, who are
ordinarily tranquil, and apparently harmless, will occasionally burst
into paroxysms of fury, and deal indiscriminate destruction to those
around them, frequently without the slightest cause, and certainly
without pre-meditation:—and whose inferior scale of intellect does not
enable them to give a reason for their actions. These states have been
mentioned that they may be recognized by the medical practitioner, and
become known to the advocate, in order that he may apply them to the
existing law.

Finally, it is necessary to observe that insanity may be counterfeited
by the criminal, in order to defeat the progress of justice;—and with
this view, may attempt to impose on the medical practitioner. During
the course of my experience I have witnessed only two attempts of
such imposture, and in both instances the deception was so clumsily
executed, that it required but little knowledge of the disorder to
detect it. To sustain the character of a paroxysm of active insanity
would require a continuity of exertion beyond the power of a sane
person;—they do not keep up the deception when they suppose themselves
alone and unwatched;—the assumed malady then disappears, and the
imposture is re-commenced when they are in the society of others. They
are likewise unable to prevent sleep. If they endeavour to imitate
the passive form of this malady, which is an attempt of considerably
greater difficulty, they are deficient in the presiding principles,
the ruling delusion, the unfounded aversions, and causeless attachments
which characterize insanity—they are unable to mimic the solemn
dignity of systematic madness, nor recur to those associations which
mark this disorder; and they will want the peculiarity of look, which
so strongly impresses an experienced observer.

       *       *       *       *       *

It now remains to treat of that morbid condition of intellect which
requires the interposition of the law to protect the person and
property of the party so affected.[61:A] The general reasoning
which has been adopted concerning insanity, in criminal cases, will
equally apply to the present subject; but there are some particular
considerations deserving attention in this part of the enquiry. The
members of the medical profession have long and anxiously endeavoured
to frame a definition of insanity, which is an attempt in a few words
to exhibit the essential character of this disorder; so that it may be
recognized when it exists;—these efforts have been hitherto fruitless,
nor is there any rational expectation that this desideratum will be
speedily accomplished. The Lawyer has taken a different view of the
subject: he has been little solicitous to become acquainted with the
physiological distinctions of disordered intellect, or the causes
producing such state:—these he has confided to the medical evidence
to explain. His enquiry has been directed to ascertain if such state
of mind prevails, as actually disqualifies the particular person
from conducting himself, or managing his affairs, and he expects
from the medical evidence sufficient proofs of such incompetence. To
this condition of intellect, when satisfactorily demonstrated, the
law applies its remedy and protection. This incapacity of conducting
himself, or of managing his affairs, arising from a morbid state of
intellect;—whether it be from perversion of mind or imbecility, is in
the estimation of the lawyer equivalent to a definition of insanity,
and perhaps it is the best that can be furnished.

    [61:A] It has been observed that the finding a commission is
    like signing the death-warrant of an individual: it certainly
    consigns his person and property to the management of others
    appointed by the chancellor. But it should be fully understood
    that this process is exclusively a process of law, and resorted
    to by the relations, or trustees for the insane person. The
    medical practitioner has no interest whatever in this legal
    instrument—on the contrary, he is generally a loser by the
    finding of the commission, which ordinarily implies (though
    improperly) a confirmed state of disease, rendering less
    necessary medical advice and attendance.

In many instances, the insanity of the person is so clear, so
evident and demonstrable, that it is immediately acknowledged by the
commissioners and jury;—in such cases the medical practitioner has
an easy duty to perform. There are however occasions where the state
of the person’s mind involves considerable doubt, and creates much
difficulty in determining: and in these equivocal and embarrassing
circumstances, the skill and experience of the physician must furnish
the documents and reasons for the decision of the jury. He is presumed,
in consequence of his previous attendance on the patient, from the
repeated conversations he has held with him, and from an attentive
observation of his conduct, to be fully informed of the state of
his mind: and as the commission is commonly granted by the medical
affidavit of the party’s lunacy, it is a natural expectation that
such medical evidence should be competent to prove to the extent he
has deposed on oath. The gentlemen who compose the jury and whose
province it is to determine on the lunacy of the party, may not be
acquainted with the different species of insanity, nor possess any
considerable knowledge of the physiology of the intellect; yet they are
entitled, and fully able to exercise their judgment, their honest and
plain sense, on those opinions and that conduct which characterize an
insane mind, and which disqualify the person so affected from having
the management of himself or of his affairs. It is the duty of the
medical evidence to become acquainted with his prevailing opinions, and
also with his propensity to act on them, to ascertain his capricious
partialities and unfounded resentments:—and whether he meditates his
own destruction, or seeks to take away the life of another. Either
of these propensities originating purely from insanity, both for the
safety of the patient and of the community claim the protection of the
law. Although the commissioners and jury have a right to expect from
the medical evidence a full developement of the patient’s condition
of intellect, yet it has not unfrequently occurred that even medical
persons have so widely differed concerning the mental state of an
individual, that one party has deposed to his sanity, and the other
has testified to his madness; if therefore such contrariety of opinion
should exist between those persons who are supposed most competent to
detect insanity, it cannot diminish our confidence in the decision of
an intelligent and impartial jury.

It may here be proper to notice that in the criminal court the
testimony of others is sufficient to establish the insanity of the
prisoner. Under a writ de Lunatico Inquirendo, superadded to the
testimony of others, the person supposed to be insane, is usually
produced before the commissioners and jury, and by them examined, in
order to confirm or invalidate the evidence which has been adduced,
and to satisfy their minds that he _is_ a lunatic at the time of
their enquiry. Although there is much fairness and impartiality in the
examination of the patient by the commissioners and jury to ascertain
by actual enquiry that his state of mind tallies with the evidence
deposed: yet it sometimes occurs, that the patient, fully aware of
the proceedings, will by subtilty endeavour to defeat them. He will
artfully conceal his real opinions and even affect to renounce such
as have been deemed proofs of his insanity, and on many occasions he
has been so skilfully tutored as to foil the united penetration of
lawyer and physician. It is on such occasions that the sagacity and
experience of the medical practitioner are demanded, and it will in
some instances occupy a considerable time to institute such examination
as shall suffice to unravel the real state of his opinions. It is
nearly impossible to give any specific directions for conducting such
examination as shall inevitably disclose the delusions existing in the
mind of a crafty lunatic; but in my own opinion it is always to be
accomplished, provided sufficient time be allowed, and the examiner
be not interrupted. It is not to be effected by directly selecting
the subjects of his delusion, for he will immediately perceive the
drift of such enquiries, and endeavour to evade, or pretend to disown
them:—the purpose is more effectually answered by leading him to the
origin of his distemper and tracing down the consecutive series of
his actions and association of ideas:—in going over the road where
he has stumbled he will infallibly trip again. If in a case of actual
insanity the medical practitioner, from inattentiveness, mistake, or
want of experience should fail to expose the real condition of the
patient’s intellect, and he should be found not lunatic, he would be
set afloat, to pursue the dictates of his perilous volition; he might
uncontrolled dissipate his property, and reduce himself and family to
beggary:—if his life were insured, if he subsisted on an annuity, or
held a commission in the naval or military service he might wander and
destroy himself, and thereby deprive his successors of their immediate
support or expected benefit:—or he might commit some outrage for which
he would be arraigned in a criminal court. The record of having been
found not lunatic by a jury legally constituted to enquire into the
state of his mind, would be the strongest bar to a plea of insanity in
a criminal court, who after such proceedings would be little disposed
to credit the theories of medical metaphysicians.

It is not necessary to enter on an investigation, or to enumerate all
the particular states of mind which may be comprehended under the
terms Insanity, Madness or Lunacy, but it is a subject of grave and
important enquiry to ascertain what degree of mental derangement, or
imbecility ought to disqualify an individual from being the master
of his person and property. It has sometimes occurred that persons
evidently under mental derangement have for months continued to
transact their affairs with prudence, and have conducted themselves
quietly in society. Notwithstanding the disordered state of their
ideas, they have not obeyed the impulse, nor followed the direction
of their insane opinions, and have forborn to act to their own
detriment or to the annoyance of others. Several of such instances
have fallen under my own observation: but the greater part have
eventually destroyed themselves, or become so furious that seclusion
was absolutely necessary. It is therefore impossible, under a state of
existing insanity to predict the future conduct of an individual thus
affected, or to become responsible for the continuance of his harmless
disposition.

In the discussion of this question it should be kept in view that the
medical evidence is called upon to state, in the first place, that
the person is of insane mind: and secondly, that in consequence of
such state, he is incapable of conducting himself or of managing his
affairs. If it be a matter of general and legitimate inference, that
a person of insane mind is consequently unable to the management of
himself and affairs; the proof of his insanity necessarily involves
his incompetency: if it be supposed that, although of insane mind, a
man may be capable of conducting himself and his affairs, it is then
incumbent on the medical practitioner to shew from the nature and
tendency of his particular insanity that he is unfit to be trusted with
either. Such prediction must necessarily be the result of copious
experience, and formed in the way of a general conclusion, and it
should be understood that this opinion of his incompetency regards
his existing condition of mind at the time of the legal enquiry.
Although a person might labour under a variety of mental infirmities,
which by medical practitioners might be technically denominated false
perception, delusion, hallucination, &c. still if these symptoms did
not go to the extent of disqualifying him from conducting himself and
managing his affairs, such symptoms in a legal point of view would,
probably, not amount to insanity, nor justify the restraint of a
commission of lunacy. It is true such symptoms seldom occur without
producing the incompetency which the law regards as the warrant for its
restraint, and fulfils the legal interpretation of insanity.

The employment of terms in an ambiguous sense has ever been the
bane of philosophy, and the obstacle to its advancement. Without the
meaning of important words be accurately defined, no general reasoning
can be established. On some occasions the term UNSOUND MIND
has been introduced, and considerable emphasis has been laid on it by
lawyers; as possessing an intrinsic meaning, and designating a peculiar
state of morbid intellect, not _precisely similar_ to insanity, but
of equivalent effect in depriving a person of the management of
himself and affairs. It is of the utmost importance that the term
_unsound mind_ should be fully and accurately considered. Had this
term originated from medical persons, it is most probable they would,
at least have endeavoured to explain it; but it is of higher descent,
and adopted by those luminaries of the law to whom we look up with
confidence and respect. The force and extent of the term unsound mind
are described in the luminous judgment of the present Chancellor on
a recent case. Of this learned exposition of the law, every medical
practitioner should be informed, as it will serve to guide him, when
he is called to give his deposition on the state of a patient’s
intellect. In the judgment adverted to, his Lordship observes, “I have
searched, and caused a most careful search to be made into all the
records and procedures on lunacy which are extant. I believe, and I
think I may venture to say, that originally commissions of this sort
were of two kinds, a commission aiming at, and enquiring, whether
the individual had been an ideot ex nativitate, or whether, on the
other hand, he was a lunatic. The question whether he was a lunatic,
being a question, admitting in the solution of it, of a decision
that imputed to him at one time, an extremely sound mind, but at
other times an occurrence of insanity, with reference to which, it
was necessary to guard his person and his property by a commission
issuing. It seems to have been a very long time before those who had
the administration of justice in this department, thought themselves
at liberty to issue a commission, when the person was represented as
not being ideot ex nativitate, as not being lunatic, but as being
of _unsound mind_, importing by those words, the notion, that the
party was in _some such state_, as was to be contradistinguished from
idiotcy, and as he was to be contradistinguished from lunacy, and yet
_such_ as made him a proper object of a commission _in the nature_
of a commission to enquire of idiotcy, or a commission to enquire
of lunacy. From the moment that that had been established, down to
this moment, it appears to me however to have been at the same time
established, that whatever may be the degree of weakness or imbecility
of the party—whatever may be the degree of incapacity of the party
to manage his own affairs, if the finding of the jury is only, that
he was of an extreme imbecility of mind, that he has an inability to
manage his own affairs; if they will not proceed to infer from that,
in their finding upon oath, that he is of _unsound mind_, they have
not established by the result of the enquiry, a case upon which the
Chancellor can make a grant, constituting a committee either of the
person or estate. All the cases decide that mere imbecility will not
do; that an inability to manage a man’s affairs will not do, unless
that inability and that incapacity to manage his affairs amount to
evidence that he is of unsound mind; and he must be found to be so.
Now there is a great difference between inability to manage a man’s
affairs, and imbecility of mind taken as evidence of unsoundness
of mind. The case of Charlton Palmer in which this was very much
discussed, was the case of a man stricken in years, and whose mind,
was the mind of a child, it was _therefore in that sense_, imbecility
and inability to manage his affairs which _constituted_ unsoundness of
mind.” This is the law, the principle established for the regulation
of medical opinion; and it will be immediately perceived, that the
burthen of this ponderous machine, turns on the explanation which
may be given to the term unsoundness of mind. As far as the term
unsound is employed and understood by medical persons, it signifies a
morbid condition of the human constitution, or a morbid state of some
particular organ, and this state of unsoundness is inferred to exist
from particular and well marked symptoms, which experience has detected
to indicate, constitutional or local morbid affections. If this term
be transferred to mind, it is equally incumbent on the person who
employs it, to point out the particular symptoms or mental phenomena
which characterize this unsoundness of the individual’s mind. It ought
to be well considered that our knowledge of the intellectual faculties,
and of their operations is very limited, and that the progress of the
philosophy of mind, has borne no proportion to the rapid advances
which have been made by Anatomy, Physiology and Pathology, in the
structure, offices and morbid alterations of the body. All that we
can know of the mind of an individual is from the communication of
his ideas in terms or signs which are conventional between us, in
order to be intelligible, or from his actions. Thus by discourse,
which is imparted to the ear, or by intelligible characters presented
to the eye, which convey his thoughts, and by his conduct, we are
enabled to estimate the character of his mind. The lawyer has been
accustomed to receive mental phenomena as the only evidences of the
state of an individual’s intellect: he would be dissatisfied, and in
my own opinion, properly, with any bodily symptoms, such as peculiar
conformation of the head, excessive determination of blood thereto,
protrusion or glistening of the eye, increased pulsation of the Carotid
arteries, &c.—these may be indications to medical persons in the
treatment of insanity, but they do not constitute any direct evidences
of mind. On the scale of intellectual capacity there is an extensive
range, some are eminently gifted, and others so sparingly supplied
that they are unfit for the common purposes of life, and require to
be protected. These are Ideots ex Nativitate. If it be attempted to
teach them, they are deficient of the capacity to acquire sufficient to
manage the property they may be possessed of, or to conduct themselves.
Is it here incumbent on the medical practitioner to state that this
natural deficiency of intellect arises from unsoundness of mind, or
that the unsoundness is the effect of such deficiency: in order that
the individual may experience the wise, politic, and humane protection
of the law?—It frequently occurs that those of extensive capacity and
high attainments are by an apoplectic or paralytic attack suddenly
deprived of their intellectual faculties, and reduced to the state of
an ideot ex nativitate. Is it in this case necessary, for the legal
protection of the party, to insist on the hypothesis of unsoundness?
Is it insufficient to detail the miserable remnants of his former
state, and exhibit to the jury the shocking spectacle? Must there be a
compulsion to infer, that this abolition of the faculties amounts to
evidence of the unsoundness of his mind? We are acquainted with the
mind from the phœnomena it displays; but the cause of these phœnomena
is to us inscrutable: by discourse and conduct we infer its soundness,
by the same evidences its unsoundness must be detected. This appears
however to militate against the dictum of law, which states, “Whatever
may be the degree of weakness or imbecility of the party—whatever may
be the degree of incapacity of the party to manage his own affairs, if
the finding of the jury is only that he was of an extreme imbecility
of mind, that he has an inability to manage his affairs: if they will
not proceed to infer from that, in their finding upon oath, that he
is of _unsound mind_, they have not established, by the result of
their enquiry, a case, upon which the Chancellor can make a grant
constituting a committee either of the person or estate.” Is not this
extreme imbecility of mind and inability to manage his affairs the only
evidence of his unsoundness of mind? if not, what further is required?
for it is not necessary, according to law, that he should be a lunatic.
If these be insufficient to constitute him of _unsound mind_, then the
inference is clear and warranted, that he may be of extreme imbecility,
and have an inability to manage his affairs, and, notwithstanding all
this, may be of _sound mind_: and if _unsoundness_, be _some such
state_, as may be contradistinguished from idiotcy and lunacy, then an
ideot and a lunatic may be of _sound mind_.

In the case referred to of Charlton Palmer, who was a man stricken
in years, and “whose mind was the mind of a child, it was _therefore
in that sense_ imbecility and inability to manage his affairs, which
_constituted_ unsoundness of mind.” Here the imbecility and inability
to manage, _did_ constitute the unsoundness: the words _therefore, in
that sense_, evidently refer to his mind being “the mind of a child,”
which is perhaps a mode of expression more familiar than accurate; as
no one could properly infer, that the mind of a child was necessarily
unsound.

If the word unsoundness be particularly examined, and for that purpose
we consult Dr. Johnson’s Dictionary, we shall find it employed in
three different senses, but no one in which it implies any particular
condition of mind:—the adjective unsound has a dozen different
meanings, but none in the sense of vitiated intellect. From authority
therefore we obtain no information. If we proceed to its derivation, we
shall find that our Anglosaxon ancestors by the word SUND (whence our
SOUND) meant precisely the Latin SANUS. UNSUND Anglosaxon, or unsound
English, would therefore be of equivalent meaning with the Latin
INSANUS.

In those instances where the word unsound is used in our own
profession, it designates something cognizable by the senses. An
unsound tooth bears in its external character or internal feeling,
sufficient evidence of its unsoundness. A fistulous sore may appear
to be healed, but the skill of the surgeon can readily detect that it
is unsound at the bottom: and both the dentist and the surgeon can
give sufficient reasons, as the foundation of their opinion. Unsound
doctrine, differs from that which is orthodox in certain particulars or
essential points, which constitute its unsoundness.

Superadded to these, let the facts be examined as they are recorded
in nature and experience. Of the human intellect there can only be
three states: sound mind, insanity, and idiotcy. Of these states there
may be different degrees. The mind of one man may be relatively more
sound than another; his attention may be more fixed and enduring—his
memory more retentive; his judgment may be clearer, and possess
superior vigour; and his imagination shall exhibit a brighter flame.
Notwithstanding this exalted capacity, the individual who is removed
many degrees lower on the scale, may possess sufficient soundness for
the purposes of his nature:—he may be capable to conduct himself, and
likewise to manage his affairs. Insanity, is another condition of the
human mind, and of this state there are various forms and different
degrees; and when a morbid state of intellect prevails, under which a
man cannot conduct himself, which implies that he is not safe to be
trusted with his own life, nor with the life of another—that in his
motives to action he cannot discriminate between right and wrong, or
without motive is irresistibly impelled to act, and therefore becomes
a being, not responsible for his conduct, and is incapable of managing
his affairs—such state implies the necessity of being guarded by the
instrument of the law: and this state of insanity, which includes all
the various terms of madness, melancholy, lunacy, mental derangement,
&c. necessarily evinces the unsoundness of the individual’s mind.
Lastly, idiotcy, which, whether it be ex nativitate, or supervene at
any period of life, implies a deficiency of intellectual capacity, to
an extent which renders him incapable of the mental offices, which
enable a man to conduct himself, and manage his affairs, and which of
necessity infers the unsoundness of his mind, and the propriety of
legal protection.

Those are the states of the human intellect which have a distinct and
separate existence, and which are capable of being described from
their manifestations; there can be no intermediate state, and certainly
no abstract or independant unsoundness: which, when it is acknowledged,
must, on the one hand, be derived from insanity, or from idiotcy on
the other. But the law has established a different system, and it is
observed that “It seems to have been a very long time before those
who had the administration of justice in this department, thought
themselves at liberty to issue a commission, when the person was
represented as not being ideot ex nativitate, as not being lunatic, but
as being of unsound mind, importing by those words, the notion, that
the party was in _some such state_, as was to be contradistinguished
from idiotcy; and as he was to be contradistinguished from lunacy, and
yet _such_ as made him a proper object of a commission, _in the nature_
of a commission to enquire of idiotcy, or a commission to enquire of
lunacy.” Accepting this with great humility as the law, it is equally
dutiful to endeavour to discover on what facts or experience it was
established: and the only clue to this investigation is found in the
words “_in some such state_,” as was neither idiotcy nor lunacy, but
“such” as disqualified him from exercising the volition of an ordinary
man, by an instrument “in the nature” of a commission applicable to
ideot or lunatic.

If this undefined unsoundness of mind, can thus dispossess the
individual of his liberty, and of the use of his property, under
the issuing of a commission, it performs sufficient; but it may be
respectfully enquired, what would be the general opinion, or that
of the commissioners of the College of Physicians, if a medical
practitioner were to give a certificate to confine a person in a
madhouse, declaring he was neither an ideot nor a lunatic, but of
unsound mind?—And what attention would the judge and jury give to a
physician in a criminal court who came to prove that a man who had
committed murder was not responsible for the crime, because he was
neither an ideot nor a lunatic, but of unsound mind; importing by these
words that he was in _some such state_ as was to be contradistinguished
from idiotcy, and as he was to be contradistinguished from lunacy?
After having taken this view of the subject, which is the result of
extensive experience in this department of the profession, and of
diligent enquiry into the nature of the human mind; it appears to me,
that the medical practitioner may safely and conscientiously infer
unsoundness of mind, if such term be legally insisted on, whenever a
morbid condition of intellect prevails, to an extent which deprives the
mind of its natural and healthy offices, by producing an incapacity or
inability in the individual to conduct himself and manage his affairs.

From the observations which have been detailed concerning unsoundness
of mind there is, according to legal construction, an evident
connection between unsoundness and imbecility. My object, however, is
not the interpretation of law, but the exposition of nature and fact.
It alone interests me to describe the phœnomena of mind—to compare the
performance of its offices in a sound and morbid state—and to measure
by the accredited standard of common sense and intelligible reasoning,
the degree of imbecility, inability, or incapacity, which disqualifies
an individual to conduct himself and manage his affairs.

The necessity of legal interference and protection in cases of
insanity, having been sufficiently adverted to; it now remains to
shew that a person from imbecility of mind may be equally incompetent
to the management of himself and affairs. The mind may be weak from
birth, or it may at any period of life become enfeebled by disease.
Like the body it has its regular periods of growth and development,
of maturity and declension: but they are not periodically connected.
An unusual precocity of mental vigour has been occasionally remarked;
and in advanced age the wisdom of the man frequently survives the
infirmities of the body. Men are relatively competent, wise or foolish,
learned or ignorant, compared with others. On the scale of intellectual
being, we may place the philosopher at the summit, at the bottom the
degraded ideot: and in the population of this world the intermediate
range is adequately filled up. There are many considerations which
demand attention on this important subject. To state that certain
acquirements were to be attained as the proof of competency, would be
an imperfect criterion. Much might be acquired _memoriter_, which the
learner would not understand: a very feeble intellect, insufficient for
the purposes of human affairs, might be trained to answer correctly
a string of known questions, without being able to comprehend or
adapt them to any useful purposes. It should likewise be considered
that the different departments of employment require very different
degrees of mental capacity. A person might be able to manage duly a
small income, who would be inadequate to the distribution of a large
revenue: a man might be competent to keep a shop, who would become
overwhelmed and distracted in the learned professions: a country
squire might gallop hospitably through life, without being able to
discharge his duty as a magistrate. It is not the want of acquirement
that should disqualify an individual; many persons from distaste,
indolence, from neglect of parents and guardians, remain lamentably
ignorant in the current acceptation of the words—they are unable to
write or read, they are unacquainted with the symbols which represent
numbers: yet with these deficiencies they are enabled to conduct
themselves in the world. Speech itself is not absolutely necessary;
because a person born deaf, and consequently dumb, if he understood the
signification of characters, called letters, and their composition,
termed words: if he comprehended that such words were significant of
such things, so that when the object was presented he could select the
appropriate word, and alternately when he saw the word could point to
the thing:—moreover, if he had learned to form these characters, he
would possess a sufficient substitute for speech, and become capable
of intelligible communication—as a correspondent he would be on a
level with him who enjoyed the utmost fluency of speech. So bountiful
has the author of nature been in the construction of the human frame,
that when one avenue to knowledge has been impervious, it has been
transmitted through the medium of another; sufficiently to constitute
the person an intelligent being and a moral agent. It is the _capacity_
of acquirement to which we are to direct our investigations. If a
scale were constructed, and a certain degree fixed as the point of
competency, the circumstance of his not having arrived at such point,
ought not to disqualify the person. It ought to be _determined_ that
he is unable to acquire so much. It is true a man may be ignorant as
far as certain acquirements, which we term learning, are concerned,
and which form the basis of ordinary education; he may know nothing
of what has passed in the world, which we denominate the history of
our species; but he may be an attentive observer of the objects in
nature, and know fully the purposes to which they are applied. Such
a man, although ignorant, does not want the capacity to acquire, and
therefore ought not to be disqualified. It has occurred to me in many
instances, to be consulted concerning persons whose minds have been
naturally weak, or enfeebled by disease; and it always appeared that
by patient enquiry, a satisfactory estimate of their capacity might
be instituted. It would extend far beyond the limits of the present
work to detail the whole of the circumstances connected with this
subject; but it may be briefly stated that the person exercising his
judgment ought particularly to ascertain the power of his attention; as
his knowledge of objects, and his memory of them, will depend on the
duration of his attention; and it will be indispensably necessary to
investigate his comprehension of numbers, without which the nature of
property cannot be understood. If a person were capable of enumerating
progressively to the number ten, and knew the force and value of the
separate units, he would be fully competent to the management of
property. If he could comprehend that twice two composed four, he
could find no difficulty in understanding that twice, or twain ten,
constituted twenty. This _numeration_ also presumes he comprehended
that so many taken from ten, or substracted which is the converse,
would leave so many as the remainder—without such capacity, no man,
in my own opinion, could understand the nature of property, which is
represented by numbers of pounds, shillings, and pence. Indeed the
capacity to acquire this knowledge seems to constitute the preeminence
of man in the creation, as an intellectual being. The same imbecility
of mind is often produced in adults, and in those of advanced age,
by paralytic or epileptic attacks, and from various affections of the
brain, and requires the same accurate investigation, to determine on
the competency of such persons, to be entrusted with the management of
themselves and affairs.

From the foregoing remarks, it appears indispensably necessary that
some criterion should be fixed as the test of sufficient capacity. In
the case even of an ideot ex nativitate, it must be ascertained that
he is really an ideot; and the same process of investigation, which
enables us to determine this fact, will apply to the intermediate
gradations of human capacity. All ideots are not of the same degree
of intellectual depravity; some possess more memory than others, and
display a talent for imitation;—they will whistle tunes correctly, and
repeat passages from books, which they have been taught by ear; but
they are incapable of comprehending what they repeat.

There is a degree of intellect, although mean, when compared with
superior minds, which will enable a human being to take charge of
himself, and transact his affairs; and there is also an inferior
degree, which incapacitates him from the performance of those offices:
and patient examinations at repeated interviews will enable the
observer to ascertain his competency, and to afford a satisfactory
evidence of the state of his mind: for the mind of every man may be
gauged, both as to its acquirements and capacity. By imbecility,
therefore, which may be either natural, or induced by a variety of
causes, it will be seen, that I mean a state or degree of mental
incapacity equivalent to ideotcy, a degree, which renders him
incompetent to the management of himself and affairs:—and which
degree, by observation and enquiry, may always be ascertained. This
degree, satisfactorily measured, does, in my own opinion, amount to
unsoundness of the individual’s mind: as it includes all the mental
evidences which constitute unsoundness.

Connected with these subjects, there is a point of considerable
importance, and of frequent occurrence, which yet remains to be
examined, and with which the present essay will conclude: namely,
the state of mind, under which, a person may legally dispose of his
property by will. Medical practitioners are often called upon to
attest the competence or incapacity of particular persons to the
performance of this act, which requires a state of disposing mind. In
many instances it is deferred to that extremity of bodily disease when
recovery is hopeless. To urge its propriety or necessity at an earlier
period, often excites alarm or despondency, and such state of feeling,
the medical attendant, in many disorders, is unwilling to excite. As a
person of liberal education, and from the enquiries he has made during
his attendance on the patient, he is justly presumed a proper judge
of his competence to dispose. This instrument is termed a will, which
does not simply imply an act of volition, but the volition of a sound
or sane mind; because a lunatic, of all men, is most the creature of
volition. The same conditions of intellect which have been heretofore
enumerated, as exempting him from punishment, and disqualifying him
from the management of his affairs, would, as far as a medical opinion
may prevail, equally disable him from disposing of his property: such
disposal involving the most important part of its management.

There is great, perhaps insuperable, difficulty in considering this
subject in a general point of view. It is presumed, that no person,
actually under a commission of lunacy, could legally dispose of his
property by will, because such instrument confides the management of
his affairs to others. But in the judgment before cited, and where
the law is expounded by the highest and most competent authority, it
appears, that the legal definition of a lunatic, implies a person
interchangeably visited by insanity and reason. “The question whether
he was a lunatic, being a question, admitting in the solution of it
of a decision, that imputed to him at one time an _extremely sound
mind_, but at other times an occurrence of _insanity_, with reference
to _which_, it was necessary to guard his person and his property by a
commission issuing.”

In the insane mind, these parentheses of reason, have been technically
denominated a lucid interval, which in a former work[102:A] I have
endeavoured to explain, as far as such state becomes obvious to the
medical practitioner. Its legal force I do not pretend to calculate.
According to the legal interpretation of a lunatic, he ought, in common
justice, at those bright periods when he possesses an _extremely
sound mind_, to be lawfully allowed the free and valid exercise of
his volition. But having noticed in the work above mentioned that
the term _interval_ is extremely indefinite, as applied both to time
and space, it is the province of the law to define its duration
and extent. As a constant observer of this disease for more than
twenty-five years, I cannot affirm that the lunatics with whom I
have had daily intercourse, have manifested these alternations of
insanity and reason. They may at intervals become more tranquil, and
less disposed to obtrude their distempered fancies into notice. For
a time their minds may be less active, and the succession of their
thoughts consequently more deliberate;—they may endeavour to effect
some desirable purpose, and artfully conceal their real opinions,
but they have not abandoned or renounced their distempered notions.
It is as unnecessary to repeat that a few coherent sentences do not
constitute the sanity of the intellect, as that the sounding of one
or two notes of a keyed instrument, could ascertain it to be in tune.
To establish its sanity it must be assayed by different tests, and it
must be detected to be as lucid on the subject of those delusions,
which constituted its insanity, as on topics of a trivial nature. But
the law alone must determine whether it will consider an individual
sane act as a lucid interval, and infer soundness of _mind_, which is
the abstract term for all the intellectual phenomena, and implies the
aggregate of the ideas, of the individual, from a single and successful
effort.

    [102:A] Vide Observations on Madness and Melancholy pages 44
    and 210.

If the performance of a sane act by an insane person should be deemed
valid, let the converse of the proposition be allowed. Many who have
been of accredited soundness of mind have in some instances made such
a testamentary disposition of their property as has astonished those
who have survived them. Without apparent reason or provocation they
have left their property away from their nearest relations to public
institutions, officers of state, or to those with whom they were very
slightly acquainted. Has this single act, independently of other
concurring or collateral evidences of derangement, born the imputation
of insanity? Would the uniform tenor of sane and consistent conduct,
for many years, both prior and posterior to such act, be set aside for
this individual deed? If it should, then long existing insanity ought
to be overlooked by a single act of consistency. The reader must be
aware that this is general reasoning, as no particular case has been
the subject of discussion. The search has been directed to a broad and
general principle, without prying into subtil distinctions;—it is
reasoning as far as a knowledge of the human intellect, in its sane and
disordered state, may be expected from medical opinion; but it presumes
not to dictate to that constituted authority denominated law, which in
all civilized nations, has been wisely established for the protection
and happiness of the community.

    _Printed by G. HAYDEN, Brydges Street, Covent Garden._



TRANSCRIBER’S NOTES


The following corrections have been made to the original text:

    Page 9: wanted the means[original has “sn” in inverted type] of
    direct information

    Page 9: subtil craziness[original has “crasiness”] of Hamlet

    Page 13: having gauged[original has “guaged”] his insanity

    Page 15: where he betrays[original has “bewray”] no derangement

    Page 18: gratuitous and groundless supposition[original has
    “suppposition”]

    Page 20: Is it[original has “is”] christian-like to deem him

    Page 36: These apparitions[original has “apparations”] were
    obtruded

    Page 54: although it[original has “its”] deserves the fullest
    consideration

    Page 58: where he perfectly recovered.[period missing in
    original]

    Page 60: witnessed only two attempts[original has “at-attempts”
    hyphenated across a line break]

    Page 64: state of the person’s[original has “persons’s”] mind

    Page 73: obstacle to its advancement.[period missing in
    original]

    Page 79: medical persons in[original has “person sin”] the
    treatment

    Page 89: if such term be[original has “he”] legally insisted

    Page 100: but the volition[original has “voli-lition”
    hyphenated across a line break] of a sound





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